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Difficult Transfers
2. What are strategies you use for patient’s next cycle with a prior very difficult transfer?
‐ mock transfer to map cervix 34% ‐ dilation prior to start of cycle 22% ‐ dilation at time of retrieval 21%
‐ hysteroscopic Tx 9%
‐ schedule transfer under anesthesia 9%
‐ other: laminaria, relaxants, cervical suture 7%
Additional strategies
Other strategies at time of transfer
• Ask for help
• Vary patient position (e.g., knee chest) • Use os finder for slight dilation
• Last resort at time of transfer:
– Tenaculum or cervical suture (several times in career, never < 10%)
Strategies before next transfer
• Pre‐cycle laminaria
• Dilation/ hysteroscopy
• Misoprostol
• Placement of cervical suture
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PRECONGRESS COURSE 14 I BARCELONA, SPAIN – 1 JULY 2018 33
